The role of chemokines in type 1 diabetes‐associated neuropathy

Abstract

AbstractIntroductionTo investigate whether circulating chemokines contribute to the development of diabetic peripheral neuropathy (DPN) in patients with type 1 diabetes (T1D).MethodsFifty‐two patients with childhood‐onset T1D (mean age 28 ± 4 yrs.; diabetes duration 19.5 ± 5.5 yrs.) and 19 control subjects (mean age 26.5 ± 4.5 yrs.) were included in a cross‐sectional analysis of this long‐term longitudinal cohort study. A subgroup of 24 patients was followed prospectively for a further 10 yrs. Plasma levels of Th1‐ (CXCL9, CXCL10 and CXCL11), Th2‐ (CCL17 and CCL22) and Th17‐associated (CXCL8 and CCL20) chemokines were assessed in all subjects. Additionally, the TID patients underwent clinical examination and electroneurography.ResultsThe frequency of neuropathy was 21% (11/52). Higher levels of CXCL9 levels were found in patients with DPN compared with control subjects (p = .019); by contrast, no difference between patients without DPN and control subjects was seen after adjustment for multiple comparisons. In patients with DPN, CXCL10 correlated negatively with suralis MCV and suralis SNAP (rho −0.966, p < .001 and rho −0.738, p < .001, respectively) and was positively correlated with the vibration perception threshold (rho 0.639, p = .034), while CXCL8 correlated negatively with the cold perception threshold (rho −0.645, p = .032). The frequency of neuropathy increased to 54% (13/24) in the subgroup of 23 TID patients, followed by an additional 10 yrs.ConclusionsChanges in Th1‐ and Th17‐associated chemokines were associated with impaired peripheral sensory nerve function and nerve conduction after long disease duration in childhood‐onset T1D.